| NPI | 1205997160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 040092) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 22571) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-04-24 |